What’s criminal about suicide? Withholding access to it

On Aug. 18, just before noon, 83-year-old Gillian Bennett dragged a mattress from her home on Bowen Island, B.C., lay down on the beach and ingested a lethal dose of barbiturates.

She left behind a letter eloquently explaining her decision, how she was suffering from dementia and wished to die on her own terms. Ms. Bennett also pleaded with legislators to adopt legislation allowing physician-assisted death so others like her wouldn't have to rely on do-it-yourself methods.

The death generated a lot of discussion in Canada, especially because it came as the Supreme Court was preparing to hear a constitutional challenge to the Criminal Code provision that makes assisting suicide a crime punishable by up to 14 years in prison.

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(Ms. Bennett's husband Jonathan was by her side when she died, but she steadfastly refused to allow him to do anything, even carry the mattress, for fear he would be prosecuted for assisting in her suicide.)

In the subsequent public debate about the wisdom of allowing assisted death, one key question has gone unanswered: How many people with terminal illnesses actually kill themselves now?

Ms. Bennett is certainly not alone. Last year at this time, an elderly couple with numerous health problems, both Holocaust survivors, jumped from the balcony of their Toronto apartment. Another Toronto couple had ended their lives in similar circumstances earlier in the year. But such cases are anecdote, not data.

A new study out of Britain offers some interesting insight. The group Dignity in Dyingfound that, in England, about 7 per cent of people who die by suicide are suffering from terminal illness.

The data are not rock-solid because, while death certificates list cause of death, they do not always detail underlying conditions. We also know that like drug overdoses, many suicide deaths are not listed as such, so the number is likely an underestimate.

Most people who die by suicide suffer from mental illness, such as depression or schizophrenia. But it's clear that some people who are mentally competent make rational decisions to take their own lives. So for the sake of argument, let's say it's 7 per cent of recorded cases.

In Canada, where there were 3,728 recorded suicides in 2011, that would translate to about 260 suicides by terminally ill people. Would those people opt for physician-assisted death if that was an option? We don't know.

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What is clear, though, is that offering the terminally ill the choice of a planned death – a physician injecting a cocktail of barbiturates and muscle relaxants – is far more humane than the current options.

Instead, what we have in Canada today is sick and dying people jumping off balconies and stockpiling their medications so they can poison themselves – many reduced to searching Google for "how to kill yourself painlessly."

We also have terminally ill patients who sign do-not-resuscitate orders, or who routinely refuse food and water and starve themselves to death.

Finally, there are "suicide tourists," people with the means and the relative good health to travel to countries like Switzerland, where assisted death is legal.

Susan Griffiths, a 72-year-old Winnipeg woman suffering from multiple systems atrophy, took this route in April last year. Like Ms. Bennett, she chose to publicize her death to push for the legalization of assisted death in Canada, but we don't know how many other Canadians make similar decisions.

We should do a better job of treating pain and alleviating end-of-life suffering. That we need better, more broadly available palliative care is a given. But when that suffering becomes unbearable, when the hope is gone, some people want to hasten death.

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Choosing to die is not an easy decision, and few people will make that choice; all told, perhaps a couple of hundred each year in a country where there are a quarter of a million annual deaths. But having that choice – that right – should be a given in a democratic society.

Taking your own life is not a crime, but being denied the ability to do so in a dignified manner, as is currently the case in Canada, is criminally cruel.

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